Individual
NIELS LUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14 ARAPAHO ROAD, ARAPAHOE, WY 82510-0014
(307) 856-9281
Mailing address
1870 S 1100 E, SALT LAKE CITY, UT 84105-3414
(817) 271-3303
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11393353-2401
UT
225100000X
Physical Therapist
Primary
PT-1923
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679119242
—
WY
Enumeration date
11/19/2019
Last updated
06/01/2020
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